MEDICARE: MRS. DORIS M KONYHA ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP1968712	FL

General Provider Information

NPI Number	:	1053388751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DORIS M KONYHA ARNP

Provider Business Mailing Address
First Line	:	PO BOX 1028
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34673-1028
Country	:	US
Telephone Number	:	727-372-3632
Fax Number	:

Provider Business Practice Location Address
First Line	:	9912 LITTLE RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-3419
Country	:	US
Telephone Number	:	727-869-4248
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	07/08/2007

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